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The Rastelli Procedure for Transposition of the Great Arteries: Resection of the Infundibular Septum Diminishes Recurrent Left Ventricular Outflow Tract.

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Presentation on theme: "The Rastelli Procedure for Transposition of the Great Arteries: Resection of the Infundibular Septum Diminishes Recurrent Left Ventricular Outflow Tract."— Presentation transcript:

1 The Rastelli Procedure for Transposition of the Great Arteries: Resection of the Infundibular Septum Diminishes Recurrent Left Ventricular Outflow Tract Obstruction Risk  Bahaaldin Alsoufi, MD, Abid Awan, MD, Ahmad Al-Omrani, MD, Mamdouh Al-Ahmadi, MD, Charles C. Canver, MD, Ziad Bulbul, MD, Avedis Kalloghlian, MD, Zohair Al-Halees, MD  The Annals of Thoracic Surgery  Volume 88, Issue 1, Pages (July 2009) DOI: /j.athoracsur Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 The surgical method used in the Rastelli cohort (A) Right ventricle incision is placed away from epicardial vessels and retraction sutures are placed to provide exposure to the ventricular septal defect (VSD) and tricuspid valve apparatus. (B) The VSD is routinely enlarged by excision of a wedge of the septal tissue anterosuperiorly using an 11 blade. In addition, excision of a large portion of infundibular septum beneath the aortic valve is usually done. (C) A cylindrical patch is used to construct the baffle with running sutures to the right ventricular tissue. (D) The patch should be redundant to provide an unobstructed baffle between the left ventricle and aorta. (E) Right ventricle outflow reconstruction is completed with a homograft valved conduit. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Freedom from permanent pacemaker implantation after the Rastelli operation. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Freedom from right ventricle (RV) to pulmonary artery (PA) conduit change after the Rastelli operation. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

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